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Rosen and Lachs “Resident to Resident Aggression in Long Term Care Facilities:” Attempted to characterize the spectrum of RRA With a Focus Group Study of staff and Elders who could reliably self report. 107 participants 16 Focus Groups Staff (11 different Job categories) Elders

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Two Most Common 100% of the groups and 72% of the participants identified some form of “Verbal Abuse”, like yelling, or screaming or telling someone to “Shut Up” 94% of the groups and 64% of the participants discussed “Physical Abuse”, like pushing, hitting, physically threatening

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Where and When Most Frequent in the Dining Room or Resident Rooms Most frequent in the afternoon Though it does occur through out the day and setting.

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Hey That’s my Chair “They think they’re always sitting in that chair that is their chair and if somebody sits there…” “…they own their chairs and if somebody’s sitting there and doesn’t want to move I’ve seen one person pick up her walker… thank God at that moment I was walking by”

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The Question is…. “If” 80% to 90% of those living in Nursing Homes are afflicted with cognitive impairment How much of what we do “well intentioned” sets up triggers for aggressive behavior

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From the Elders Point of View Environment (Set Up) Assessment (Do we know Really Know who we‘re dealing with) Approach (Valuing the Elder above what he/she has lost)

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Smaller is Better Increases possibility of individualized care Less noise More opportunity for choice More opportunity for privacy

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Getting Along “There is always something more pleasant to do than beat someone up” Mohamed Ali